Kornimate/medical-research-clean huggingface dataset:
deformable registration of multi-parametric mri to intra-operative transrectal ultrasound for prostate brachytherapy

Conditions: Prostate Cancer

Summary: objective: to focus the high dose radiation to the gross tumor in the prostate while maintaining adequate dose for control of microscopic disease elsewhere in the prostate. in order to test the incorporation of the robust mri and trus fusion algorithm in the clinical setting the investigators planned a study of focused therapy with a primary endpoint of accurate localization of the high risk region. this is a pilot study of dose painted permanent i-125 seed implant to verify absence of tumor cells outside a high risk region using multi-parametric mri and deformable trus registration. the high risk region will be dose painted to 160 gy and the rest of the prostate will receive the normal prescription dose.

primary end-point: feasibility of dose painting will be determined by the absence of tumor outside the high-risk region on an intra-operative trans-perineal biopsy. frozen sections will not be obtained, however on receipt of the final pathology 2-4 weeks after the procedure 2 possible scenarios arise: 1. there is no evidence of cancer: this confirms the accuracy of the trus mri registration. 2. there is evidence of tumor on the stereotactic biopsy: in this case a regular dosimetric check (this is performed in the standard of care procedure and is known as post-operative dosimetry) will be performed to determine whether adequate dose was delivered. if not, as the involved needle position was recorded in the treatment plan and labeled with co-ordinates, the regular possibility of accurately adding radioactive seeds is possible.

Eligibility criteria:
inclusion criteria: * men suitable for monotherapy with permanent iodine 125 implant * age \> 50 yrs * ps 0-2 (who) * histologic diagnosis of prostate adenocarcinoma made on transrectal guided prostate biopsy with no fewer than 12 cores taken * no more than 50% of cores involved (summary) * mri of prostate with diffusion weighted imaging and dynamic contrast enhancement with demonstrable lesion compatible with biopsy result * gleason sum no greater than 3+4 =7 in any core * clinical t stage no higher than t t (tumor) 2a * prostate volume ≤60 cc * serum prostate-specific antigen (psa) no higher than 15 ng/ml * no prior history of malignancy except non-melanoma skin cancer * must be suitable for general or spinal anesthesia exclusion criteria: have anesthesia surgical assignment category iv or greater * cannot cease anti-coagulant therapy * had a malignancy, other than prostate or skin cancer (except malignant melanoma), within 5 years * urethral stricture * prior prostate cancer therapies

Keywords: image guided brachytherapy
treatment of overweight children and adolescents

Conditions: Overweight

Summary: the intervention program "obeldicks light" is developed for overweight children aged 8-16 years. this intervention is gender - and age specific. the 6-month intervention is based on nutrition course, behaviour therapy and exercise therapy. the evaluation compromised quality of structure, process and results of the intervention. 300 participants in a randomised controlled group design will be evaluated at 4 time points: baseline, end of intervention, 6 months after end of intervention and 12 months after end of intervention.primary outcome measure is change of weight status as standard deviation score of bmi. drop-outs will be interviewed to improve the intervention.


Eligibility criteria:
inclusion criteria: * overweight children exclusion criteria: * primary disease
improving assessment (and ultimately outcomes) of permanent prostate implant therapy

Conditions: Prostate Cancer

Summary: permanent prostate implants are a type of radiation therapy in which a high dose of radiation is delivered to cancerous tissue by many small radioactive "seeds". studies of early-stage prostate cancer patients treated in this way and followed for 10 - 12 years indicate a cure rate of about 80%. this result is similar to surgery and other forms of radiotherapy, but comes with fewer side effects and greater convenience for the patient. further studies show that the radiation dose delivered is the most important factor in achieving a cure. at present this dose is estimated by a computer, using a computed tomography (ct) scan of the patient and a simple calculation method. the dose estimate is not as accurate as it could be, however, because the precise extent of the prostate is hard to determine from the ct scan, and the calculation method does not make use of information about patient body tissues. the researchers propose to eliminate these inaccuracies by using magnetic resonance imaging (mri) to identify the prostate gland and by developing an improved dose calculation algorithm that includes information about patient tissues. this new approach will allow physicians to assess implant quality with greater certainty, improve their implant technique, and ultimately increase the cure rate to as much as 95%.

this study addresses three major sources of post-implant dosimetry inaccuracy for permanent prostate implants: post-operative edema, prostate contour delineation, and dose calculation method. it is hypothesized that a pragmatic edema model can minimize the first uncertainty, co-registered ct + mr images the second, and an improved dose calculation algorithm the third. detailed objectives are to: * measure and model the effects of edema on dosimetry; * evaluate ct + mr image registration methods; * compare dosimetry for ct alone vs. ct + mri using the contemporary tg-43 dose calculation method; * set up a monte carlo code that makes full use of the information in ct + mr images to perform implant dose calculations; * compare prostate dosimetry for the monte carlo vs. the simpler tg-43 method; * develop an analytical post-implant dose calculation algorithm for routine clinical use (monte carlo is too slow on a single-cpu brachytherapy planning computer); and finally * assess the performance of the new algorithm. of the estimated 250,000 new cases of prostate cancer in north america in 2004, most are early stage disease as a consequence of psa testing. permanent prostate implant therapy is a major option for this group, as long-term clinical studies indicate a cure rate equal to surgery and external beam radiotherapy, but with fewer complications. by dealing with dosimetric inaccuracies, a proven treatment can reach its full potential.

Eligibility criteria:
inclusion criteria: * candidate for permanent prostate implant exclusion criteria: * not ambulatory

Keywords: brachytherapy implant radiotherapy
be fast vs. fast: a study in the general public.

Conditions: Stroke

Summary: a randomized, blinded prospective study assessing retention of two stroke mnemonics (be fast and fast) in the general public after receiving brief stroke education. participants were randomized to one of two education arms and retention was tested at 3 different time intervals.


Eligibility criteria:
inclusion criteria: 1. subject 18 years of age or older 2. subject speaks english (does not need interpreter) 3. subject able to read english 4. subject willing to provide a phone number for future follow up 5. subject willing and agreeable to up to 2 phone follow up calls 6. subject willing to provide verbal consent to participate exclusion criteria: 1. subject non-english speaking (needs interpreter) 2. subject has visual or hearing impairment 3. subject has history of dementia or a learning disability 4. subject had stroke education within the past year 5. subject had a previous stroke

Keywords: be-fast fast
a study investigating coagadex in the treatment afxd associated with al amyloidosis

Conditions: Acquired Factor X Deficiency

Summary: the purpose of this study is to evaluate the efficacy and safety of coagadex in treating active bleeds and to manage peri-operative bleeding in participants with acquired factor x deficiency associated with al amyloidosis.

this study is designed to evaluate the efficacy and safety of coagadex® in treating active bleeds and to manage peri-operative bleeding in participants with afxd associated with al amyloidosis. coagadex® is a plasma-derived human coagulation factor concentrate expected to treat bleeding episodes in patients with afxd associated with al amyloidosis by delivering concentrated factor x to address the clotting deficiency caused by the disease. afxd is a rare condition (prevalence of \<1 / 1 000 000 \[orphanet 2024\]) and may occur due to infections, neoplastic and chronic diseases (lee g et al., 2012). afxd is considered severe when the fx coagulant activity (fx:c) level is \< 25% of normal (normal range 70 - 150 iu/dl), and moderate when fx:c level is 25% to 50% of normal (choufani et al., 2001). al amyloidosis is the most common cause of acquired fx deficiency (afxd). in al amyloidosis, amyloid fibrils bind to and reduce the levels of circulating fx and shorten its half-life, causing afxd, leading to an increase in risk of bleeding. bleeding may occur both in patients with moderate and severe deficiency

Eligibility criteria:
inclusion criteria: 1. male or female participants ages 18-70 years old. 2. diagnosis of afxd associated with al amyloidosis with fx:c ≤ 50 iu/dl. 3. woman of childbearing potential (defined in appendix 2) and men of reproductive potential who agree to use an effective contraception measure during the study. exclusion criteria: 1. female participants that are pregnant or lactating. 2. presence of fx inhibitors. 3. uncontrolled arterial hypertension. 4. on anticoagulant therapy (not antiplatelets), unstable heart disease, clinically significant thrombotic event in the past 180 days or any other condition that the investigator believes is likely to interfere with evaluation of the study drug or with satisfactory conduct of the trial. 5. any factor x containing product taken within 2 weeks of first coagadex® administration. 6. participation in another interventional clinical study with an investigational drug, biologic, or device within 30 days prior to screening. 7. hemodynamically unstable due to any cause or even after blood transfusion, fluid resuscitation and pharmacologic or volume replacement pressor therapy. 8. prior history of bleeding disorder other than afxd.

Keywords: factor x deficiency blood coagulation disorders hematologic diseases hemorrhagic disorders light chain amyloidosis al amyloidosis
gemcitabine combined with endostar and envafolimab in elderly patients with locally advanced nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: gemcitabine combined with endostar and envafolimab in elderly patients with locally advanced nasopharyngeal carcinoma


Eligibility criteria:
inclusion criteria: * aged ≥65 years with newly pathologically confirmed npc * karnofsky performance status ≥60 * clinical stage iii-iva (union for international cancer control and american joint committee on cancer staging system for npc, 8th edition) * adequate organ function exclusion criteria: * cancer history * prior radiotherapy, cytotoxic chemotherapy, immunotherapy or target therapy * life-expectance within 6 months
functional mri of the lower extremities

Conditions: Peripheral Arterial Disease

Summary: in this project, the investigators propose to use high-resolution magnetic resonance imaging (mri) to measure blood perfusion in different groups of calf muscle. this imaging approach is standard of care for evaluation of coronary artery disease (cad), and has never been successfully applied to pad. preliminary results show distinct patterns of muscle perfusion between healthy and pad patients, and thus great promise of the technique. the investigators will first verify the reproducibility of the technique, and then compare the calf muscle perfusion measures in pad patients against healthy age-matched controls. this comparison will test the feasibility of detecting functional abnormality in pad patients. after the baseline scans, the pad patients will opt to undergo a 12-week supervised exercise therapy, and then a post-therapy mri scan. comparison of the pre- and post-therapy measurements will indicate how the therapy improves the calf-muscle perfusion, and how this perfusion change correlates with increases in patient's walking ability. the long term goals of this project are to develop an improved diagnostic test for patients with pad to predict who will benefit from therapeutic intervention. the mri perfusion studies of calf muscle can be performed in conjunction with routine peripheral mr angiography to assess the functional significance of vascular stenosis.


Eligibility criteria:
inclusion criteria: pad patients with * intermittent claudication * ankle-brachial blood-pressure index (abi) \< 0.9 exclusion criteria: * estimated glomerular filtration rate (egfr) \< 30 ml/min/1.73m2 * chronic pulmonary diseases * arthritis or other joint ailments
utility of clinical examination in the noninvasive prediction of aortic atheroma - a prospective study

Conditions: Atherosclerosis

Summary: aortic atheroma has been correlated with traditional cardiac risk factors, coronary, carotid, renal and peripheral atherosclerosis, and is probably a manifestation of generalized atherosclerosis. aortic atheroma has also been shown to be associated with atrial fibrillation, aortic valve sclerosis, and other calcification of the fibrous skeleton of the heart. none of the previous studies have looked at the noninvasive prediction of aortic atheroma using the history and physical signs of cardiovascular disease. this would be a time and cost-effective bedside diagnostic tool that would be useful prior to cardiac surgery, cardiac catheterization, and workup of ischemic stroke patients, especially when transesophageal echocardiogram (tee) is being considered for diagnosis but cannot be obtained due to previously mentioned reasons. although physical examination of peripheral vascular disease is non-specific, a combination of physical examination signs increases the probability of generalized atherosclerosis.


Eligibility criteria:
inclusion criteria: * all consecutive patients who are referred for transesophageal echocardiography (tee) since the primary endpoint is diagnosis of aortic atheroma on tee exclusion criteria: * no exclusion after consent for tee is obtained. decision not to perform tee at the discretion of treating physician

Keywords: aortic atheroma
functional instability in patients suffering from collagen disease and joint hypermobility

Conditions: Hypermobility Syndrome; Danlos Disease, Ehlers; Collagen Diseases; Joint Hypermobility; Laxity of Ligament

Summary: a joint is considered "hypermobile" when it has a greater range of motion than normal for a given age, ethnicity or gender. many people have asymptomatic hyperlaxity in multiple joints, a condition called generalized joint hypermobility (gjh). conversely, hyperlaxity can be symptomatic, a condition that has been defined "joint hypermobility syndrome" - jhs. diagnosis of jhs is commonly performed by applying the revised brighton criteria. based on these criteria, an individual is diagnosed with jhs with a beighton score \>/= 4/9, and arthralgia for 3 or more months in 4 or more joints (major criteria). the dynamic body balance test (i.e. the stability test with multiple single-leg jumps) can provide information regarding the effectiveness of the feedforward and feedback mechanisms in correcting the postural deviations necessary to achieve successful performance during daily and sporting activities. such assessment may also be useful to demonstrate deficiencies in balance, especially in young patients with increased physical activity. the aim of this study is to examine the postural balance of individuals with jhs by performing stability tests in monopodalic and bipodalic stance with the "delos postural proprioceptive system"


Eligibility criteria:
inclusion criteria: * patients with moderate (beighton-horan joint mobility index score from 3 to 4) or severe (beighton-horan joint mobility index score from 5 to 9) joints hyperlaxity at the clinical evaluation exclusion criteria: * obesity (bmi \> 25) and weight \> 90 kg * practice of competitive sport * orthopedic (complex surgery of the spine and lower limbs), neurological (spasticity, stroke), and oncological comorbidities * orthostatic / walking inability * absence of joints hyperlaxity at the clinical evaluation (beighton-horan joint mobility index score from 0 to 2)
the impact of vitamin d supplementation on glucose metabolism in chinese women with former gestational diabetes mellitus

Conditions: Gestational Diabetes Mellitus

Summary: vitamin d deficiency are related to insulin resistance and impaired beta-cell function.it is reported that the level of vitamin d is lower during pregnancy and postpartum in the women with gestational diabetes mellitus. the investigators hypothesize that vitamin d supplementation to women after birth with previous gestational diabetes may improve glucose metabolism.

gestational diabetes mellitus (gdm) is defined as any degree of glucose intolerance that is first identified during pregnancy, excluding diabetic patients diagnosed before pregnancy. gdm can not only have an adverse effect on the pregnant women and the developing fetus, but also can have long lasting effects after birth. gdm can elevates risks of abnormal glucose metabolism postpartum. vitamin d deficiency has been shown to be associated with insulin resistance and impaired β-cell function. our previous research also implied that the level of vitamin d is much lower in the women of impaired glucose regulation after birth with history of gdm. this prospective randomized, control clinical trial was designed to evaluate the effects of vitamin d administration on insulin resistance and β-cell function among women with vitamin d deficiency（25ohd \<50 ng/ml）and previous gdm. participants with vitamin d deficiency and previous gdm were divided into normal glucose regulation group(ngr) (n=90) and impaired glucose regulation group(igr)(n=90) according to the oral glucose tolerance test (ogtt) around 42 days postpartum. and each group was further divided into intervention group and control group, participants in the intervention group took 1600 units of vitamin d daily for nine months and meanwhile receive lifestyle intervention. the control group only receive lifestyle intervention. this study aimed to evaluate the impact of vitamin d supplementation on insulin sensitivity, pancreatic β-cell function and markers of inflammation in chinese women with former gdm and vitamin d insufficiency.

Eligibility criteria:
inclusion criteria: 1. with previous gdm,40-50 days after birth - 2. with deficiency of vitamin d(25-(oh)d3\<50nmol/l) exclusion criteria: 1. type 1 diabetes，type 2 diabetes and other type of diabetes 2. server disfunction of liver and kidney（alt \>100u/l，cr\>132ummol/l） 3. with mental disease,sever anemia,sever infection,sever heart disease,now is taking asprin, immunosuppressive agent,antiepileptic drugs 4. pregnancy or plan to pregnant in one year 5. can't understand the requirement of this study 6. disfunction of thyroid

Keywords: gestational diabetes mellitus vitamin d postpartum
effect of lowering iop in glaucoma suspects with hm

Conditions: Glaucoma, Suspect; High Myopia

Summary: currently, whether and when intraocular pressure (iop) lowering medication should be used in glaucoma suspects with high myopia (hm) is still a dilemma. randomized trials are required to evaluate whether iop lowering influences the incidence of glaucoma suspect progression in hm eyes.

hm is associated with increased prevalence of glaucoma. however, accurate diagnosis of glaucoma in hm is a challenge. more and more viewpoints had been raised that hm eyes with optic disc head damage or/and visual field (vf) defects should been classified as glaucoma suspects. iop is the only modifiable parameter in glaucoma and glaucoma suspect patients. however, the decision to begin treatment to lower iop in the glaucoma suspect patient is complex, especially for glaucoma suspects with hm. there are lack of guideline and consensus of treatment choices. therefore, it is necessary to investigate the effect of medically iop lowering on the progression of glaucoma suspects with hm.

Eligibility criteria:
inclusion criteria: 1. aged between 35 and 65 years. 2. diagnosed with high myopia (spherical equivalent ≤ -8.00 diopters or axial length ≥ 26.5 mm). 3. diagnosed with glaucoma suspect, which cannot be explained by myopic macular changes, or other retinal and neurologic condition. 4. iop ≥ 12 mmhg and ≤ 24mmhg on at least 2 visits, as measured by goldmann applanation tonometry. 5. an open anterior chamber angle as based upon gonioscopy. 6. best corrected visual acuity (bcva) ≥ 6/12. exclusion criteria: 1. allergy to prostaglandins. 2. advanced vf loss (md worse than 16 db) or a threat to fixation (sensitivity 10 db or worse affecting either or both test points closest to the point of fixation in the upper hemifield and at either or both of the corresponding test points in the lower hemifield) in either eye. 3. previous iop-lowering surgery in the study eye (i.e. trabeculectomy, ahmed glaucoma valve implantation, any laser trabeculoplasty). 4. previous cataract surgery in the study eye. 5. previous corneal refractive surgery in the study eye. 6. clinically significant or progressive retinal disease such as proliferative diabetic retinopathy, retinal detachment, central retinal vein occlusion, or retinitis pigmentosa in the study eye. 7. chronic, recurrent or severe inflammatory eye disease in the study eye (from screening), such as chronic or recurrent uveitis. 8. obvious corneal and iris lesions, or severe cataracts interfering with fundus examinations, or monophtalmia. 9. need for ocular surgery/laser or anticipated need for cataract surgery that would influence the ophthalmological parameters measured in this study during the study period. 10. other serious systemic diseases (i.e. hypertension, heart disease, diabetes, or rheumatic immune system diseases). 11. pregnant or nursing women.

Keywords: glaucoma, suspect high myopia intraocular pressure